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Member Terminations

Steps to follow for member terminations

When terminating a member on Group Administrator Portal*

  1. Verify that the member’s current residential contact information is complete and up to date (address, phone, email)
  2. Enter the termination date
  3. Indicate the reason under cancellation reason
  4. Advise member that there are various options regardless of state of health

Provide the member with the correct Group Conversion Flyer for their location:

  • Atlantic provinces (Advise member they should contact Medavie Blue Cross within 60 days to avoid both lapse in coverage and waiting periods.)
  • All other provinces (Advise member they should contact Medavie Blue Cross within 30 days to avoid both lapse in coverage and waiting periods.)

*Important: Please ensure all information entered on GA Portal is accurate and current prior to terminating the member.


New enhancements to the Group Administrator Portal

Great news for users of our Group Administrator Portal (GAP)!

We have put in place a series of enhancements to the user experience and functionality of our Group Administrator Portal over the past several months, leveraging your feedback to continually add new features that reflect how this tool is used.

We are pleased to share with you the latest enhancements to this important tool, including:

  • Printable Member Card: users can now access a printable version of a member’s ID card from the Update Member screen.
  • Waive waiting period: users now have the ability to waive a member’s waiting period when adding a member – and make benefits effective starting on the hire date.
  • Issue prompts added Contact Us Page: the Contact Us page now prompts users to select an Inquiry Type – allowing us to more quickly direct the request the team equipped to provide support.

Detailed steps for these changes are available in the GA Portal User Guide. We will advise you when further enhancements are made.

Thank you for your support and feedback as we continue to work to deliver a positive experience for our business partners. This is a key focus of our organization, and we continually invest significant resources toward enhancing our systems and technology to better serve you.

We look forward to continuing to improve your client experience as this project moves forward. If you have any questions or comments, or would like to review these enhancements in detail, please contact your Medavie Blue Cross representative.


Overage Dependent Report:

Please note that the termination date field does not currently reflect the correct termination date. To determine whether a dependent is approaching the minor or student maximum age, it is important to refer to the birthdate of the dependent. For example: If your contract minor/student maximum ages are 21 to 26, those dependents with birth years of 1998 and 1993 will be approaching the maximum. Therefore, they will need to be updated either as full-time students or have their coverage terminated, depending on their situation.


Invoice

Medavie Blue Cross created an improved consolidated invoice, offering detailed information in an easier-to-read format. Only one payment is required (or paid through pre-authorized payment) for all the benefits listed on the new invoice, including specialty products. Please note that all invoices will be sent electronically, you can find more information in the toolkit’s ebills section.

New features of the invoice:

  • PDF invoice can be provided at the policy level or division level with or without member details
  • All invoices include adjustment codes to support administration changes make from the prior month
  • The invoice report is a user friendly report which provides the ability to filter and subtotal data
  • The invoice backup report has the option to include a reporting attribute (cost center) and/or an alternative identification number

Please speak with your Medavie Representative for more information.


Administration

Rate Calculator: We also enhanced our billing process to calculate coverage amounts based on the actual effective and termination dates of each member, meaning that we no longer need to defer an effective date to the first day of the month or subsequent month.

Student process changes: Medavie Blue Cross will no longer be mailing letters advising of over-age dependent status. Reports are available through your Group Administrator Portal access.


Member Services

With the latest version of the Medavie Mobile app, members can:

  • Submit a claim just by taking a photo, and view claims history
  • Search benefit details, including prescription drug coverage
  • Find an approved local health professional
  • Use and share a mobile ID card

Find out more about our ePay, eClaim and Direct Deposit services here. In addition, our Direct Deposit is now going paper free.


Group Administrator Portal Update for MAAX policies effective September 17, 2018

The current process allows 31 days to backdate a member termination with no claims check. The updated process will be as follows:

New Portal process

  • Claim Check will be done on all backdated terminations - checking, Hospital, Travel, EHB, Drug and Dental claims
  • If a claim incurred after the requested termination date, the transaction will be stopped
  • There will be display messaging advising the Group Administrator of the last date of service a claim was paid
  • Group Administrator can continue the termination using the incurred claim date provided

Portal Updates

Fully Insured Policies

  • 31 Days to backdate a member termination
  • Health, Dental, Travel Claims Check

ASO & Retention Policies

  • 180 Days to backdate a member termination
  • Health, Dental, Travel Claims Check

**Please ensure that invoices are reviewed on a monthly basis to ensure proper enrolment including additions, terminations and changes in coverage.

If you have any questions or comments, please feel free to reach out to your Medavie Blue Cross representative for further information.


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